49D2307718 CLIA NUMBER - WYTHE PHYSICIAN PRACTICES PEDIATRICS

Laboratory Demographics

  • CLIA Code: 49D2307718
  • Facility Name: WYTHE PHYSICIAN PRACTICES PEDIATRICS
  • Facility Address: 590 WEST RIDGE RD, SUITE J
    WYTHEVILLE, VA
    ZIP 24382
  • Facility Phone: 276 228-2405
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MATTHEW E. ANEY
  • NPI Number: 1043486152
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 49D2307718
LAB Type Physician Office
Facility Name WYTHE PHYSICIAN PRACTICES PEDIATRICS
Street 590 WEST RIDGE RD, SUITE J
City WYTHEVILLE
State VA
ZIP 24382
Phone 276 228-2405
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/15/2024
Certificate Expiration Date 7/14/2026
Facility Type Physician Office
Lab Director MATTHEW E. ANEY

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This page was last updated on: 6/4/2025